7. Confirm Response Message Type (MT-ACK-1)
7.3. MSA – Message Acknowledgement Segment
SEQ ELEMENT NAME LEN DATA
TYPE
Usage Cardinality Comment/
Description
1 Acknowledgment Code 2 ID R [1..1] 7.3.1
2 Message Control ID 20 ST R [1..1] 7.3.2
3 Text Message 80 ST X [0..0]
4 Expected Sequence Number 15 NM X [0..0]]
5 Delayed Acknowledgment Type 1 ID X [0..0]
6 Error Condition 250 CE X [0..0]
7.3.1. MSA-1 Acknowledgment code (ID)
HL7 Definition: This field contains the acknowledgment code, per the HL7 message processing rules.
Refer to HL7 Table 0008 - Acknowledgment code for valid values (Note: Table 0008 does not appear in Appendix B).
In this table, the value “CA” corresponds to “Enhanced mode: Accept acknowledgment: Commit Accept.” This value means that the receiving system has committed the message to safe storage in a manner that releases the sending system from the need to resend the message.
ELINCS Specification: In the Result Confirm Response interaction (IN-5), acknowledgement messages are intended to confirm specifically that a message has been received and committed to safe storage.
Hence, the value of MSA-1 Acknowledgement Code in the MT-ACK-1 message type should be hard coded to:
CA
7.3.2. MSA-2 Message control ID (ST)
HL7 Definition: This field contains the message control ID of the message sent by the sending system. It allows the sending system to associate this response with the message for which it is intended.
ELINCS Specification: Note that the combination of the values in MSA-2 Message Control ID and MSH-6 Receiving Facility should be unique to the recipient of the acknowledgement message (i.e., the Order Fulfiller).
Appendix A: Tests Requiring LOINC Coding in OBX Segment
The following table lists the test analytes that must be identified using LOINC codes3 in the ELINCS specification (i.e., in the OBX-3 Observation Identifier field). The tests comprise common laboratory tests and lab tests required to calculate HEDIS measures. These tests were selected because they (1) represent the top 80% of laboratory tests performed based on sample files provided by three sources in California, or (2) represent the tests that are most useful for quality-improvement programs related to HEDIS, and (3) represent a manageable set of tests to LOINC encode in a reasonable time.
The following defines each column in the tables of this appendix.
Test Category: A high-level grouping of tests. This is not intended to represent the constituents of common “panels” (such as CBC’s, basic metabolic or urinalysis panels), but simply to group tests editing and browsing purposes. Note that tests associated with HEDIS measures are explicitly identified.
Test: This is the common test name for specific analytes that should be mapped to LOINC codes.
Test Description: This gives more descriptive information regarding the test analytes and should be sufficient to identify the specific tests requiring LOINC coding.
LOINC Code(s): The LOINC codes that correspond to the named tests. Laboratories may also use the definitions of these tests as specified in the LOINC standard (see www.loinc.org) to identify the specific tests in their test masters that require LOINC coding. Analyses may have many LOINC codes referring to the same analyte. For example, the information in this column indicates that any tests with the LOINC code 4548-4, 4549-2, 17855-8, or 17856-6 qualifies as a hemoglobin A1c test.
Comparable CPT Code(s): This column shows the CPT codes that are specified at the level of test purpose or specific to the test. Note that the information in this field does not necessarily provide a one-to-one mapping from LOINC codes to CPT codes, or vice-versa. Some analytes (e.g., BANDS) do not have their own CPT codes, but may belong to panels (such as CBCs) that do have associated CPT codes.
Sample Values: This column simply shows some example values for the results of the indicated tests.
3
Logical Observation Identifiers Names and Codes (LOINC) is a standard, non-proprietary
coding system for laboratory tests and other clinical observations. LOINC codes uniquely
identify tests based on a combination of their features, including the analyte being measured,
the specimen being tested, and the test methodology being used. Over 25,000 LOINC codes
exist for laboratory tests. See www.loinc.org for additional information.
Test
Purpose Test Test Description LOINC Code(s)
Comparable BANDS Neutrophil bands, patient
blood, quantitative
1.14 K/uL BASOPHILS Basophils, patient blood
quantitative
0.1 K/uL BASOPHILS % Basophils as percent of total
leukocytes EOSINOPHILS Eosinophils, patient blood
quantitative
0.1 K/uL EOSINOPHILS % Eosinphils as percent of
total leukocytes
4%
LYMPHOCYTES Lymphocytes, patient blood quantitative
3.1 K/uL LYMPHOCYTES % Lymphocytes as percent of
total leukocytes
MCV Mean Corpuscular Volume,
patient RBC, quantitative
MONOCYTES Monocytes, patient blood quantitative
2.4 K/uL MONOCYTES % Monocytes as percent of
total leukocytes
3%
MPV Mean Platelet Volume,
patient blood quantitative
9.23 fL MYELOCYTE Myelocytes, patient blood
quantitative
1%
NEUTROPHILS Neutrophils, patient blood quantitative
1.5 K/uL NEUTROPHILS % Neutrophils as percent of
total leukocytes
53%
NUCLEATED RBC'S Neucleated Erythrocytes, patient blood quantitative
/100 WBC PLATELETS Platelets, patient blood
quantitative
RBC MORPHOLOGY Red Blood Cell
WBC White Blood Cells
(Leukocytes), patient blood
BUN/CREAT RATIO Urea Nitrogen/Creatinine ratio, patient serum/plasma, quantitative
13 GLOBULIN (CALC) Globulin (calculated),
patient urine quantitative EPITHELIAL Epithelial cells, patient
urine quantitative
URINE BILIRUBIN Bilirubin, patient urine quantitative
NEGATIVE URINE BLOOD Blood, patient urine
quantitative
MEDERATE,
1+
URINE COLOR Urine Color, nominal STRAW
URINE KETONE Ketones, patient urine quantative
NEGATIVE, 40
mg/dL URINE NITRITE Nitrite, patient urine
quantative
NEGATIVE
URINE PH PH, patient urine quantative 5.0
URINE, RBC RBC, patient urine quantitative URINE UROBILINOGEN Urobiligen, patient urine
quantative
0.2 EU/dL,
NORMAL URINE, WBC WBC, patient urine
quantitative
ALT Transferase; alanine amino, patient serum/ plasma, quantitative
84460
24 U/L
ALT/SGPT Alanine Amino Transferase:
Aspartate Amino BILIRUBIN, DIRECT Bilirubin direct, patient
serum/plasma, quantitative
82248
0.1 mg/dL BILIRUBIN, TOTAL Bilirubin total, patient
serum/plasma, quantitative
CALCIUM Calcium, total patient blood
quantitative
CHLORIDE Chloride, patient blood
quantitative
82435
99 mmol/L CHOL/HDL RATIO Total Cholesterol/HDL
Cholesterol ratio, patient serum/plasma quantitative
80061
3.2 CREATININE Creatinine, patient blood
quantitative
LDL/HDL RISK RATIO LDL Cholesterol/HDL Cholesterol ratio, patient serum/plasma quantitative
80061
3 OCCULT BLOOD Hemocult Blood, patient
stool, qualitative
POTASSIUM Potassium, patient serum
quantitative
84132
4.5 mmol/L PROTEIN, TOTAL Total Protein, patient serum
quantitative
RHEUMATOID FACTOR Rheumatoid factor, patient serum quantitative
TSH, SERUM Thyroid Stimulating Hormone, patient
serum/plasma quantitative
84443
1.51 mIU/L URINE GLUCOSE Glucose, patient urine
quantitative
Urine Albumin Albumin, patient urine quantitative Urine Protein Protein, patient urine
quantitative
LDL-Cholesterol LDL Cholesterol, patient serum/plasma quantitative HDL-Cholesterol HDL Cholesterol, patient
serum/plasma quantitative Total Cholesterol Total Cholesterol, patient
serum/plasma quantitative
14647-2, 2093-3,
32308-9
150 mg/dl
Triglycerides Triglycerides, patient
serum/plasma quantitative
HEDIS:
Colorectal Cancer Screening
Fecal Occult Blood Test Hemoglobin, patient stool nominal
Chlamydia Trachomatis
Culture
specimens include cervical swab, vaginal swab, and urine sediment
6349-5, 14463-4, 14464-2, 14467-5
Text Result
Chlamydia Trachomatis
Antigen Detection
specimens include cervical swab, vaginal swab, and urine sediment
Chlamydia Trachomatis
DNA Probe
Chlamydia Trachomatis
rRNA Probe
specimens include urine 4993-2, 16602-5
not available
Appendix B: Enumerated Value Tables
HL7 Table 0001 - Administrative sex
Value Description F Female M Male O Other
HL7 Table 0038 - Order status
Value Description
A Some, but not all, results available CA Order was canceled
CM Order is completed DC Order was discontinued ER Error, order not found HD Order is on hold
IP In process, unspecified RP Order has been replaced SC In process, scheduled
HL7 Table 0065 - Specimen action code
Value Description
A Add ordered tests to the existing specimen G Generated order; reflex order
L Lab obtained specimen from patient
O Specimen obtained by service other than Lab
HL7 Table 0070 - Specimen source codes
Value Description
ABS Abscess AMN Amniotic fluid
ASP Aspirate BPH Basophils BIFL Bile fluid BLDA Blood arterial
BBL Blood bag
BLDC Blood capillary BPU Blood product unit BLDV Blood venous
BON Bone
BRTH Breath (use EXHLD) BRO Bronchial BRN Burn
CALC Calculus (=Stone)
CDM Cardiac muscle
CNL Cannula
CTP Catheter tip
CSF Cerebral spinal fluid
CVM Cervical mucus
CVX Cervix COL Colostrum BLDCO Cord blood
CNJT Conjunctiva CUR Curettage CYST Cyst
DIAF Dialysis fluid DOSE Dose med or substance
DRN Drain
DUFL Duodenal fluid EAR Ear
Value Description EARW Ear wax (cerumen)
ELT Electrode ENDC Endocardium ENDM Endometrium EOS Eosinophils RBC Erythrocytes EYE Eye
EXG Exhaled gas (=breath) FIB Fibroblasts FLT Filter FIST Fistula
FLU Body fluid, unsp GAS Gas
GAST Gastric fluid/contents GEN Genital
GENC Genital cervix GENL Genital lochia GENV Genital vaginal
HAR Hair
IHG Inhaled Gas
IT Intubation tube
ISLT Isolate LAM Lamella WBC Leukocytes
LN Line LNA Line arterial
LNV Line venous
LIQ Liquid NOS
LYM Lymphocytes MAC Macrophages MAR Marrow MEC Meconium
Value Description MBLD Menstrual blood
MLK Milk MILK
NAIL Nail
NOS Nose (nasal passage) Other
PAFL Pancreatic fluid PAT Patient
PRT Peritoneal fluid /ascites PLC Placenta PLAS
PLB Plasma bag
PLR Pleural fluid (thoracentesis fld)
Polymorphonuclear neutrophils PPP Platelet poor plasma
PRP Platelet rich plasma PUS Pus
RT Route of medicine SAL
SMN Seminal fluid SER Serum
Skin
SKM Skeletal muscle SPRM Spermatozoa
SPT Sputum SPTC Sputum - coughed SPTT
STON Stone (use CALC) STL Stool = Fecal
Sweat
SNV Synovial fluid (Joint fluid) TEAR Tears
Breast milk
ORH
Plasma
PMN
Saliva
SKN
Sputum - tracheal aspirate
SWT
Value Description THRT Throat
THRB Thrombocyte (platelet) TISS Tissue
TISG Tissue gall bladder TLGI Tissue large intestine
TLNG Tissue lung
TISPL Tissue placenta TSMI Tissue small intestine TISU Tissue ulcer
TUB Tube NOS
ULC Ulcer
UMB Umbilical blood UMED Unknown medicine
URTH Urethra UR Urine URC Urine clean catch URT Urine catheter URNS Urine sediment USUB Unknown substance
VITF Vitreous Fluid VOM Vomitus
BLD Whole blood
BDY Whole body
WAT Water WICK Wick
WND Wound
WNDA Wound abscess
WNDE Wound exudate
WNDD Wound drainage
XXX To be specified in another part of the message
User-defined Table 0078 - Abnormal flags
Value Description L Below low normal H Above high normal LL Below lower panic limits HH Above upper panic limits
< Below absolute low-off instrument scale
> Above absolute high-off instrument scale N Normal (applies to non-numeric results) A Abnormal (applies to non-numeric results)
AA Very abnormal (applies to non-numeric units, analogous to panic limits for numeric units)
U Significant change up D Significant change down
B Better--use when direction not relevant W Worse--use when direction not relevant
S Susceptible. Indicates for microbiology susceptibilities only.
R Resistant. Indicates for microbiology susceptibilities only.
I Intermediate. Indicates for microbiology susceptibilities only.
MS Moderately susceptible. Indicates for microbiology susceptibilities only.
VS Very susceptible. Indicates for microbiology susceptibilities only.
HL7 Table 0085 - Observation result status codes interpretation
Value Description
C Record coming over is a correction and thus replaces a final result D Deletes the OBX record
F Final results; Can only be changed with a corrected result.
P Preliminary results
X Results cannot be obtained for this observation
U Results status change to final without retransmitting results already sent as
‘preliminary.’ E.g., radiology changes status from preliminary to final W Post original as wrong, e.g., transmitted for wrong patient
HL7 Table 0123 - Result status for OBR segment
Value Description
O Order received; specimen not yet received
I No results available; specimen received, procedure incomplete S No results available; procedure scheduled, but not done A Some, but not all, results available
P Preliminary: A verified early result is available, final results not yet obtained C Correction to results
R Results stored; not yet verified
F Final results; results stored and verified. Can only be changed with a corrected result.
X No results available; Order canceled.
Y No order on record for this test. (Used only on queries) Z No record of this patient. (Used only on queries)
HL7 Table 0125 - Value type
Value Description
AD Address CE Coded Entry
CF Coded Element With Formatted Values CK Composite ID With Check Digit
CN Composite ID And Name
Value Description CP Composite Price
CX Extended Composite ID With Check Digit DT Date
ED Encapsulated Data FT Formatted Text (Display) MO Money
NM Numeric PN Person Name RP Reference Pointer SN Structured Numeric ST String Data.
TM Time
TN Telephone Number TS Time Stamp (Date & Time) TX Text Data (Display) XAD Extended Address
XCN Extended Composite Name And Number For Persons XON Extended Composite Name And Number For Organizations XPN Extended Person Name
XTN Extended Telecommunications Number
HL7 Table 0155 - Accept/application acknowledgment conditions
Value Description
AL Always NE Never
ER Error/reject conditions only SU Successful completion only
HL7 Table 0190 – Address Type
Value Description
B Firm/Business
BA Bad address
BDL Birth delivery location (address where birth occurred) BR Residence at birth (home address at time of birth) C Current Or Temporary
F Country Of Origin H Home
L Legal Address
M Mailing
N Birth (nee) (birth address, not otherwise specified) O Office
P Permanent
RH Registry home. Refers to the information system, typically managed by a public health agency, that stores patient information such as immunization histories or cancer data, regardless of where the patient obtains services.
HL7 Table 0200 - Name type
Value Description
A Alias Name
B Name at Birth
C Adopted Name
D Display Name
I Licensing Name
L Legal Name
M Maiden Name
N Nickname /"Call me" Name/Street Name
P Name of Partner/Spouse (retained for backward compatibility only) R Registered Name (animals only)
S Coded Pseudo-Name to ensure anonymity T Indigenous/Tribal/Community Name U Unspecified
HL7 Table 0203 - Identifier type
Value Description
AM American Express
AN Account number BA Bank Account Number BR Birth registry number BRN Breed Registry Number DI Diner’s Club card DL Driver’s license number
DN Doctor number
DR Donor Registration Number
DS Discover Card
EI Employee number
EN Employer number
FI Facility ID
GI Guarantor internal identifier GN Guarantor external identifier HC Health Card Number
JHN Jurisdictional health number (Canada)
LN License number
LR Local Registry ID
MA Medicaid number
MC Medicare number
MCN Microchip Number
MR Medical record number MS MasterCard NE National employer identifier NH National Health Plan Identifier NI National unique individual identifier
NNxxx National Person Identifier where the xxx is the ISO table 3166 3-character (alphabetic) country code
NPI National provider identifier
PEN Pension Number
PI Patient internal identifier
Value Description
PN Person number
PRN Provider number
PT Patient external identifier RR Railroad Retirement number RRI Regional registry ID
SL State license
SR State registry ID
SS Social Security number U Unspecified
UPIN Medicare/HCFA’s Universal Physician Identification numbers
VN Visit number
VS VISA
WC WIC identifier
WCN Workers’ Comp Number
XX Organization identifier
User Defined Table 0396 – Coding Systems
Value Description
L Local general code C4 CPT-4
HPC HCFA Procedure Codes (HCPCS) I10P ICD-10 Procedure Codes
I9C ICD-9CM
LN Logical Observation Identifier Names and Codes (LOINC(r)) SNM Systemized Nomenclature of Medicine (SNOMED)
SCT Snomed CT
User Defined Table 0362 – Sending/Receiving Facility
Value Description
CL CLIA ID assigned per the Clinical Laboratory Improvement Act
CP CLIP ID issued for DoD laboratories by Armed Forces Institute of Pathology